Background: In the United States, blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV. Increasing access to care for people living with HIV (PLWH) and reducing HIV-related disparities are key national objectives. Data-to-Care (D2C) is a public health strategy that uses HIV surveillance and other data to improve linkage, retention, and health outcomes for PLWH who are not linked to medical care.
Description: The Care and Prevention in the United States (CAPUS) project implemented in 2012-2016 by eight state health departments included a combination of interventions to reduce HIV-related morbidity, mortality, and disparities among racial/ethnic minorities. A key component of CAPUS required grantees to develop capacity to use HIV surveillance and other data to:
a) identify and help PLWH link to or re-engage with care,
b) monitor their clinical outcomes, and
c) improve the quality of care and prevention services provided to them.
We synthesized qualitative and quantitative data reported by grantees to describe their D2C implementation and outcomes.
Lessons learned: Grantees enhanced their capacity to implement D2C by improving their data systems; integrating surveillance, care and prevention data; and enacting policies and procedures for using surveillance information for program follow-up. Using multiple data systems, grantees identified and contacted 4,952 PLWH presumed to be not-in-care (64.0% blacks/African Americans, 29.2% whites, 4.1% Hispanic/Latino). Of those, only 36.6% were confirmed as not-in-care (41.6% of blacks/African Americans, 30.9% of Hispanic/Latinos, 25.2% of whites). Linkage services were provided to 57% of those confirmed as not-in-care (60.5% of blacks/African Americans, 58.7% of Hispanics/Latinos, 42.5% of whites). Overall, 82.4% of those provided linkage services were linked to or re-engaged with medical care (84.4% of blacks/African Americans, 78.4% of Hispanics/Latinos, 69.7% of whites).
Conclusions/Next steps: CAPUS grantees enhanced their capacity to use surveillance and other data to identify PLWH who were not-in-care and link to or re-engage them with medical care. Better outcomes for blacks/African Americans and Hispanics/Latinos, compared to whites, suggest that D2C programs that prioritize racial/ethnic minorities may help address disparities in access to HIV medical care. Further improvements in data systems and outreach services are essential for the success and scale-up of D2C programs.